A cardiac pacing system that includes an implantable pulse generator and electrical leads that include a lead body portion having a distal end and a proximal end, a connector configured to electrically connect the proximal end of the lead body to the pulse generator, and at least one electrode disposed at the distal end of the lead body for delivering electrical stimulation to a patient's heart, wherein the distal end of the lead body is configured to terminate within the mediastinum of the thoracic cavity of the patient, proximate to the heart.

A surgical rib refractor is disclosed. The surgical rib retractor includes a housing having at least one cam surface. The surgical rib retractor also includes an anterior arm unit configured to receive one rib. The surgical rib retractor further includes a posterior arm unit configured to receive another rib. The surgical rib retractor also has an actuator movable relative to the housing and operationally coupled to at least one of the anterior and posterior arm units to move said at least one of the anterior and posterior arm units against the at least one cam surface to create a relative movement between the anterior and posterior arm units, said relative movement comprising at least two directional components.

A cardiac pacing system that includes an implantable pulse generator and electrical leads that include a lead body portion having a distal end and a proximal end, a connector configured to electrically connect the proximal end of the lead body to the pulse generator, and at least one electrode disposed at the distal end of the lead body for delivering electrical stimulation to a patient's heart, wherein the distal end of the lead body is configured to terminate within the mediastinum of the thoracic cavity of the patient, proximate to the heart.

A lead receptacle having a lumen configured to traverse from an outer side of an outermost intercostal muscle to an inner side of an innermost intercostal muscle of an intercostal space of a patient and to support a lead traversing through the lumen. The lumen being configured to support one or more cardiac leads traversing through the intercostal space.

A surgical assembly is disclosed. The assembly has a cannula. The cannula has an oblong opening on a proximal end, one or more textured features on an outside, and a stabilizer at the proximal end. The assembly also has an obturator sized to fit within the cannula from the proximal end of the cannula. The obturator has a tapered end configured to extend from the distal end of the cannula and a protrusion on a proximal end of the obturator configured to engage a portion of the cannula.

A lead receptacle having a lumen configured to traverse from an outer side of an outermost intercostal muscle to an inner side of an innermost intercostal muscle of an intercostal space of a patient and to support a lead traversing through the lumen. The lumen being configured to support one or more cardiac leads traversing through the intercostal space.

A medical device delivery system including a delivery sheath that includes an internal lumen, and a plurality of delivery arms contained within the internal lumen of the delivery sheath and extending along a longitudinal axis of the internal lumen of the delivery sheath, wherein distal ends of the delivery arms include fasteners configured to engage with a basal structure of a medical device and a apical structure of the medical device, wherein the delivery arms are attached to delivery arm controls that are configured to advance the delivery arms and the medical device attached thereto out from a distal end of the delivery sheath, and removable release wires or release lines configured to engage with the fasteners to hold the basal structure and the apical structure in place at the fasteners. Also disclosed are methods of delivering a medical device to a subject including inserting a distal end of the medical device delivery system through an incision in the skin of subject, and deploying a medical device engaged with the delivery arms of the medical delivery system to within the body of the subject.

A surgical access assembly for accessing a cavity of a patient includes a proximal frame member, a distal frame member, and a membrane between the proximal and distal frame members. The proximal frame member is positionable adjacent an external surface of tissue and has first and second frame portions movable between a contracted condition and an expanded condition to expand an opening defined therethrough. The membrane defines a loop disposed about at least a portion of the proximal frame member at a proximal end thereof and is engaged to the distal frame member at a distal end thereof. The membrane is transitionable between a crumpled condition and an extended condition upon transitioning of the proximal frame member between the contracted condition and the expanded condition.

A surgical access device includes a body having a first member and a second member relatively movable between open and closed configurations. Each member is positionable within an opening in tissue to provide access to an interior space of a patient. Each member includes a top surface, a bottom surface, a leading end, and a trailing end. The top surfaces are positioned in close cooperative alignment when the first and second members are in the closed configuration. The trailing ends are positioned in close cooperative alignment when the first and second members are in the open configuration. In the open position, the first and second members define a passage therethrough to permit access to the interior space for passage of a surgical instrument therethrough.

Devices and methods for positioning a surgical instrument are described herein. In one embodiment, a positioning device can include a base that can be placed against tissue and a shuttle including a lumen that can receive a surgical instrument. The lumen can be translated in at least two directions relative to the base and an orientation of the lumen relative to the base can be polyaxially adjusted. Further, the device can include a locking mechanism that, upon actuation, prevents both translational movement and polyaxial movement of the lumen relative to the base.